We’ve all watched older loved-ones struggle with what were formerly routine chores and ponder what can be done to make life easier for them: Aging in place can be a great choice.
The benefits to of aging in place are so clear: the freedom and dignity that come from staying in your own home, the ability to make your own decisions, the maintenance of friendships and community ties, versus the often the high cost of assisted living and associated disorientation and new social stresses.
The good news is, there’s a whole industry dedicated to helping people modify their homes. But doing so can be a stressful and expensive endeavor. That’s why you need to understand the details of home modifications and the impact — before you get started.
The first thing to understand is there’s no such thing as one-size-fits-all design for aging in place. We’re all unique. Our houses are, too. You have a first-floor master, I have a second-floor suite. You climb steps at the front door, I enter through the garage. You have arthritis, I have trouble balancing. “Right” means right for you, your home, your mobility and your wallet.
A good place to start is universal design, which refers to products and spaces that can be used by the widest range of people, including the handicapped. . Think of it as a design insurance policy. The best time to do it is before you develop significant health or mobility issues.
Here are 9 considerations:
1. One-floor design vs. elevator Most so-called experts will tell you that living on one floor is unequivocally the best way to go. But that’s not always the case. Many single-floor houses have long hallways. If strength or stamina is an issue or if walking is difficult, an elevator might make more sense.
Installing one that connects the area where you spend a lot of time on one floor to important spaces on another can significantly reduce time on your feet. Another advantage is that you can also roll a full cart into an elevator so you don’t have to carry bags, packages, laundry, etc.
But elevator location is a tricky design problem. For one thing, the shaft takes up space on all floors. Then you must build in extra maneuvering space to enter and exit on foot, with a walker or in a wheelchair. On top of that, the cost of construction and installation can be prohibitive: from $30,000 to $65,000 — plus ongoing maintenance costs.
Placing the shaft outside the house walls is even more expensive because you must excavate, install footings, break through to the interior and finish the new exterior, in addition to heating and cooling the new space.
2. No-step entry It’s definitely a good idea to have at least one of these. But there’s a host of related issues that go beyond the construction work. Outside, you’ll probably want a covered entry to protect you from the elements. And you need good drainage since the doorway will be level with the walking surface just outside the door. Once inside, you’ll need space for maneuvering.
If it’s too complicated or expensive to create a no-step entry at an existing doorway, think outside the box. Could you turn a window into a doorway to enter a larger area or turn a small or underused room into a new foyer? A fringe benefit could be making the living room less of a hallway.
Ramps are also an important feature to review in conjunction with house access from the site. But ramps are usually very long and require careful planning and can be unsightly if not well-conceived. Simple wood ramps can run 3-5k, concrete with masonry easily $10-20k
3. Widened doors and railings Expanding the width of doorways is useful to accommodate wheelchairs and walkers as well as people with any kind of mobility issues. Wider doors allow two people to cross at the same time. But altering doorways can be difficult. Challenges include carrying the structural load from floors and roofs above and rerouting wires or mechanical systems that are located in the walls next to the door. You also need a plan for patching the floor space where the walls used to be. Typical costs approximately $800-1300. Thoughfully located railings and grab bars make it easier for those with balance issues to grasp a secure “anchor” and move ahead: costs can range from $100 to 800.
4. Pocket doors While these space-savers do create more maneuvering room, they present a challenge that most people don’t anticipate. First, creating the pocket requires exposing enough wall area for two door widths. Second, as generally installed, pocket doors can only accommodate flat handles, which are difficult to grasp, even by people with full manual dexterity. To make space for a regular door handle, you will need to install a wider door in a wider opening so the fully open door sits outside the pocket and allows a more easily grasped handle.
5. Stair glide This is one of the most common pieces of aging-in-place equipment, but it has some drawbacks. The most basic chair lift (the kind that runs straight up and down) costs about $3,000, installed. But custom units for stairs that have turns and landings can run as high as $12,000. While glides can be a godsend for people with heart conditions or bad knees, they are not ideal for people with bad hips or who have difficulty sitting or balancing in a seated position.
Another issue: People who use a walker or wheelchair will need one on each floor. They’ll also need help getting into and out of the glide at all transfer points. Furthermore, there must be maneuvering space for you and your assistive devices on both floors. I have seen a lot of homes with idle stair glides because they didn’t help in the way owners expected them to.
6. Walk-in tubs Some of the biggest confusion about aging in place centers on bathroom choices. One example is the hugely popular walk-in tub, which at first might seem like a brilliant idea.
A tub with a door sounds like it would be much easier and safer to access than a conventional tub. Unfortunately, what people fail to realize is that with most walk-in tubs, you have to maneuver very carefully through a narrow door and then get out of the way as the door swings shut. And you still have to climb over a low step. So if your walking or flexibility is compromised, this unit won’t be effective.
Think about how you take a bath: You generally fill the tub with water before you climb in. But with a walk-in, you enter first and close the door — then you sit there waiting for the water to fill. When you’re done, you have to drain out all the water before you can reopen the door to exit. Manufacturers recognize the issue because they list speedy drain times in their advertising. But not everyone is comfortable with this arrangement.
Beyond that, walk-in tubs are pricey — around $10,000 installed — so consider the difficulties and limitations before you shell out the money. The best solution is a curbless shower, with no hurdles to overcome when entering or exiting.
7. Built-in shower seats These are an increasingly common feature yet are often not utilized the way they were intended because most seats are placed too far from the showerhead and controls. As a result, most are typically used to prop up your foot while shaving your legs or as a big shelf. A movable seat is a better (and less expensive) solution. You can adjust the placement to your needs or remove it to maximize maneuvering space. To optimize a seat, you also need a handheld shower handle that you move instead of moving yourself back and forth. This should be mounted on an adjustable grab bar, not mounted on a slide bar that won’t support you.
8. Glass shower doors. Many people think glass shower or tub doors are an upgrade, but sliding doors block half the opening, making entry/exit more challenging. It also makes helping a seated bather a near impossibility. Swinging doors block your reach to a solid (i.e., mounted) grip on the wall. Your best bet: a good old-fashioned $20 shower curtain.
9. Lighting:, It comes as no surprise that ones vision weakens as we age and in particular the amount of light we need to distinguish objects, changes in floor levels and the like are critical in avoiding dangerous situations. So particular attention needs to be taken as to the amount and location of lighting that is installed in an elderly home, particularly around stairs and bathrooms.
Some other handy links:
Guide to Room-by-Room Repairs for Easy Accessibility for Disabled Loved Ones – This handy guide will help you make an accessibility plan for your bathrooms, kitchen and yard – three of the most treacherous places for individuals with disabilities.
11 Low-Cost Aging in Place Modifications You Can Do Yourself – Fortunately, not every safety upgrade requires an arm and a leg, and many can be done DIY!
Senior’s Guide to Paying for At-Home Long-Term Care: How Your Home Can be a Great Asset – Your home can actually be a great tool for paying for any needed accessibility modifications – without having to sell it! This guide offers seniors ideas for funding options their home can provide to pay for both minor and major updates.
How to Make & Pay for Home Modifications to Enable Aging in Place – In addition to your actual home, there are more options than you might be aware of to fund safety upgrades. This guide offers lots of helpful tips and links to other resources for helping you fund your home modifications.
Please call me to review your or your loved-one’s situation, Steve 914 980 5532
